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Tue Jul 29 10:11:02 BST 2003

Ken,

You know how much I admire you, but in all respect, I think you're
over-reacting here.  Given the habit of the media to find fault in
healthcare, a patellar reflex is to be expected; but for a moment, consider
that there might be a baby in USA Today's bathwater, too.

The limitations of lay coverage in print media notwithstanding, I believe
that it's fair and accurate to report that a) EMS effectiveness is
significantly related to time-efficiency, and b) by and large, we are
generally not scrutinizing time management as closely or consistently as is
merited.  "Response time" is not a useful performance indicator because, as
the article suggests, "response" is not reliably defined from agency to
agency, or even provider to provider.  Many (if not most) EMS units cannot
usefully examine, compare, or improve their time management strategies
because their data is not controlled (GIGO).  In its defense, the article
credits Seattle, Boston, OK City and Tulsa as examples by which others may
be measured...

Such is in no way intended to suggest that individual EMS units or providers
are endangering their communities through neglect, much less to minimize the
overall importance of prehospital services to the health and safety of any
community.  If anything, the USA Today erred in not balancing its critique
with credit where it is due.  But I think the author and editors succeeded
in demonstrating that our systems suffer from subjective performance
measures.  Indeed, I'm guessing you'll soon see state and municipal systems
re-defining their data tools in direct response to this very bit of
journalism--and that our systems will be so improved.

So scold Gannett for not first recognizing the overall excellence of
prehospital EMS; but as for me, I'd congratulate them for a valuable
criticism of how we measure our performance.

Also, I'd ditch the Hope reference.  It's not a clean segue.

Very Respectfully,

Pret Bjorn
Trauma Coordinator
EMMC Trauma Program
489 State Street
Bangor, ME 04401

207.973.7260 (office)
207.973.7673 (fax)
207.941.5085 (voice pager)

 -----Original Message-----
From: KMATTOX at aol.com [mailto:KMATTOX at aol.com]
Sent: Monday, July 28, 2003 9:19 PM
To: trauma-l at lists.aast.org; trauma-list at trauma.org
Subject: Draft of Letter to USA Today-Cesar Ursic suggested it, now lets do
it

Cesar, Jeff, and others.    

Here is a draft skeleton you might use to begin to get consensus:

USA Today published the passing of a man who almost reached immortality
during this life (Bob Hope).  We join the world in mourning his death and
sending condolences to his family and world of friends.   Unfortunately, in
the same issue (July 28, 2003), an article led the world to believe that if
medical care in the form of EMS reaches a patient with ventricular
fibrillation, then everyone should expect that these members of the health
care continuum will always be able to restore life to the lifeless.  The
article (and others to be published the next few days) leads the world to
believe that our EMS system is broken and is depriving many patients their
chance of immortality.   Yes, there are turf issues and we can alway
improve, but the pre-hospital care in the United States, coupled with
standardized systems of trauma care, stroke care, cardiac care, and
resuscitation is the very BEST IN THE WORLD.   However, even when the health
system at any level does its best, the "bad result" which was encountered
may not be made better or totally reversed, it might even get worse.   This
is not always the fault of a broken EMS, Emergency medicine, trauma care,
operation, or critical care structure, but is the nature of the disease
process.   The base data referred to in the article actually documents
something the American public should be proud of.  The use of that data in
the article is actually misleading and misconstrued.   It is like answer C
on a standardized examination, "True, True, but Unrelated."   

Let the readers of USA Today know that continual improvements in
catastrophic care from prevention to alerting to pre-hospital care, to
emergency center resuscitation, to operation, to critical care have and will
continue to be a focus of dedicated men and women who risk their lives every
night and day to assure that the latest and best is offered to those in
need.   Let us not throw out the baby with the bath water, but focus on the
real "root causes" of concerns for the barriers to quality health care in
America.   

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Draft of Letter to USA Today-Cesar Ursic suggested it, now le ts do it